On September 27, the World Heart Day, 2009 was marked and as expected the World Health Organisation (WHO) tasked all on "working towards wellness." The global body said that cardiovascular diseases were the world’s largest killers, claiming 17.5 million lives a year. It said that risk factors for heart disease and stroke included raised blood pressure, cholesterol and glucose levels, smoking, inadequate intake of fruits and vegetables, over- weight, obesity as well as physical inactivity.
What is Heart Disease?
The term heart disease actually applies to a number of illnesses that affect the circulatory system, which consists of heart and blood vessels. It is intended to deal here only with the condition commonly called "Heart Attack" and the factors, which lead to such condition.
Heart attack is the popular term for sudden pain in chest with breathing difficulty arising out of certain heart conditions. Heart attacks can be suddenly fatal, but the great majority- an estimated 85 percent are not. The patient recovers under proper treatment and goes on to live many useful years.
Like all muscles and organs of the body, the heart also needs nourishment and food which it gets thorough its own arterial system. The arteries, which supply blood to the heart muscle, may lead to impairment of its function. The sudden narrowing of the artery may result in the sudden stoppage of blood supply to the heart muscle. Such attacks of narrowing of arteries are called angina. If the damage takes place it is called infarction.
Infarction can also occur because of a blood clot, big enough to interfere with blood supply, is formed in the coronary artery. This formation of blood clot is called trombosis and the clot itself is known a thrombus. The term coronary heart disease is usually applied to diseases of the heart secondary to defective or interrupted supply of blood to the heart muscles through the coronary arteries.
Besides the sudden narrowing of coronary arteries such as in anginal attacks or thrombosis, the blood supply to heart muscle could also be impaired by certain long term and (chronic) conditions like arteriosclerosis and atherosclerosis.
Arteriosclerosis is a condition when certain arteries (may be all) start losing their elasticity and their walls, due to some unknown factors, become thickened and hardened. When this happens, blood pressure inside the arteries tends to become high and which in its wake puts more stress and strain on heart.
Recent researches in connection with heart diseases have demonstrated a high correlation between fats in the diet, cholesterol level and atherosclerosis. Cholesterol is fat like substance found in animal fats, oils and some tissues of the human body.
Some Early Signs Of Heart Trouble
It has been said earlier that any disturbance in the supply of blood to heart muscle leads to its functional impairment.
It will be useful to discuss here such factors, which may lead to disturbances in the supply of blood to heart muscles. Certain conditions increase the strains on the heart. Among these are lack of rest, over exertion or prolonged hard labor which create an excessive body demand for oxygen that the heart, muscle must supply through pumping more blood. If the blood vessels are inelastic on account of arteriosclerosis fibrous thickening or narrowing of passage (atherosclerosis) additional work on the part of the heart will be needed to push blood through these vessels. Other indirect factors that may result in causing disturbance in blood supply are indigestion of food, anger and other emotional excitements.
There are some early symptoms, which may be important to watch for. Their appearance calls for a visit to the doctor for a check up. The symptoms are:
• Angina – classically this is felt in the middle of the chest, behind the breast bone and is variously described as crushing, squeezing, tightening, "pressure like a weight". It may also go across the chest, typically into the left arm, but can be felt in the shoulder, neck and sometimes lower jaw. It is typically brought on by exercise, emotion and cold weather. It is relieved by rest. It is caused by inadequate blood supply to the muscle of the heart.
• A typical chest pain – ie almost any chest pain can be a symptom of heart disease and needs evaluating by an experienced physician
• Angina is often mistaken for indigestion. This is one reason why "indigestion" needs investigating properly.
• It is quite common, especially for fit young men, to get stabbing left sided chest pains, in slightly stressful situations. Obviously they need investigating properly but usually no heart disease is found.
• Shortness of breath – only too often, this is put down to lack of fitness. Shortness of breath occurs because there is not enough blood being pumped round the lungs to pick up oxygen and drop off carbon dioxide. Most people when they exercise, especially if they are a bit unfit, get a bit short of breath at first but then get a "second wind". If you can’t get your second wind, or if in the process of trying to get fit, you can’t get beyond a certain level, I would be concerned. If the left side of the heart starts to fail to clear the blood from the lungs quick enough, a back pressure builds up which causes fluid to build up in the lungs. This further impairs oxygen exchange and makes the shortness of breath dramatically worse. This is called pulmonary oedema. It can be heard at the bottom of the lungs and sounds like fine crackling paper when a deep breath is taken.
• Palpitations – these are often felt when the heart is beating wrongly i.e. a dysrhythmias (irregular heart beat, or a beat which is too fast or slow) or cardiomyopathy. If you have a palpitation try to think how fast it is, whether it is regular or irregular and how long it goes on for – this helps to diagnose. The pulse can be felt in many places, most easily at the wrist or groin . The normal pulse rate is anything between 60 and 100, the fitter you are, the lower the pulse rate. There is a slight variation with breathing – the pulse quickens slightly as you breath in a slows as you breath out.
• Swollen ankles – are caused when the right side of the heart fails to efficiently clear blood returning from the body. If the patient is sitting in bed, the swelling appears in their buttocks and over the sacrum. Typically it is pitting, i.e. when you press the swollen area for a few seconds, the imprint remains for a few seconds.
Fatigue and inability to get fit are often the best warning signs that the heart cannot deal with an increased work load.
Some Causes Of Heart Trouble
Heart disease has been more frequently found in certain persons who show peculiar personality physical and mental traits. It will therefore, be worthwhile to discuss these factors. Coronary heart disease is considered to have multiple causative factors i.e., no one single factor perhaps could be identified as one causing a heart attack.
1. Heredity – There is ample evidence to show that incidence of heart disease is more in persons whose direct predecessors like fathers, grandfathers, mothers, brothers have suffered from similar disease. Coronary artery disease is found to run mainly in families. A strong family history of the disease is important in diagnosis.
2. Stress- Heart disease has often been identified with certain personality patterns. It is labelled as personality disease or a high executive disease, that is, it strikes persons with a certain personality. A certain study has shown that there was four times as much coronary disease among aggressive type of individuals.
In addition to this other factors such as family responsibilities, interpersonal relationship, financial worries, leisure interests, habits of eating drinking and smoking etc. may play a part that may effect one’s heart.
3. Smoking – It has been found by some workers that death rate among those who had heart attack was 50-150 percent higher in those who were heavy cigarette smoker than non-smokers.
Physical Exercise – There is a fairly general trend towards encouraging regular physical effort of a kind suited to age and condition of the person concerned. As a preventive as well as a remedial measure exercise is of great importance. There is abundant evidence to suggest that a stressful sedentary life without much exercise provides a situation fraught with coronary danger. Death rate from coronary heart disease is lower among those who do strenuous physical work.
Even for patients, who have survived coronary attacks, there has lately been a change in the thinking in marked contrast in earlier ideas. The doctors are now a day advocating, after the initial prescribed rest, walking up the stairs, going on hikes, bicycles and other forms of exercise. The quantum of exercise in each case must of course be decided by the attending physician.
4. Diet and obesity – Certain studies have shown 50 percent increase in heart attacks in employees who were over weight similarly diet and amount of fat are matter of vital importance in incidence of heart disease. The sound advice which could be given is to lead a life of moderation in matter of diet and activity an also to avoid obesity. Large fatty meals and strenuous exercise after them is not conducive to a healthy heart.
Saturated fats are likely of animal origin like whole milk, cream, butter, cheese meat, fat, etc. They raise blood cholesterol level. On the other hand, unsaturated fats are of vegetable origin and they tend to lower blood cholesterol levels like maize oil, cottonseed oil sunflower oil and fat of fish.